Saturday, December 21, 2013

Seeing Things in a Different Light

Being a veterinarian for the past 18 years has allowed me to see many things and encounter many challenges when it comes to health care for my patients.  It has also created many challenges for my own health but opened many doors for possibilities.

“To take medicine only when you are sick is like
digging a well only when you are thirsty — is it not
already too late?” (Chi Po, c 2500 BC).

I like this quote as it revolves around an approach that I have undertaken for myself and many of my patients.  It is also a subject that I have found increasingly important when it comes to health, but unfortunately not shared by many.

The more I explore in my research and the more I discover with my patients, it becomes readily apparent how important preventative medicine is for overall health.  The above quote implies the importance of preventative medicine, however, the majority of people fall into the second scenario where they are seeking solutions only once disease has set in.

As a veterinarian, we are presented a multitude of clinical conditions much similar to human maladies, which could often be better managed through lifestyle, dietary changes and herbal therapies rather than medications. Often these problems could have been curtailed initially if only the proper diet or supplements were implemented, which could have enhanced health and potentially minimized future health problems.  It is a frustrating problem for a clinician, as the patient (or owner) wants a resolution to the condition but on the same side, often does not want to put much effort forth to aid in that management.

The reality is that many health problems ranging from arthritis to even various forms of cancer could be better managed through preventative therapies, which include lifestyle changes and dietary or supplement modifications.  The other reality is that people, as a whole, often don't see the purpose of intervening if there is no problem present.  They don't see the value in enhancing health to prevent disease.  This is a shame from my perspective as many conditions could be more easily managed or possibly prevented.

In our patients, we use a multitude of herbal formulas to address ongoing inflammation, impaired cellular function and oxidative stress in our patients.  Most of them present for obvious clinical problems ranging from ongoing pain, joint deterioration to overt organ damage.  Often, we can improve the quality of life for that animal, but I have to step back and wonder what if this patient had assumed this lifestyle years ago?  Would we still be contending with this problem now?  Would it have been less severe or possibly delayed by years?

We don't know the answers to these questions for a variety of reasons, with the main one being that simply owners rarely take the proper preventative approach.  In those patients that do, we often do not contend with major health problems, so it is hard to conclude if we prevented anything but just note good health.  We could have a comparison of a specific breed of dog, which may be more predisposed to allergies for instance. One would take a preventative approach, while the other a more traditional line.  I can almost be certain that the one on the proper preventative approach would be less likely to develop allergies, but if this was proven to be a fact, the opponents would contend that genetics or other factors played a part.

The whole concept of preventative health is frustrating for me as I see and read the research regarding the impact of various herbs and nutrients on pathways involved in cancer, diabetes, cardiovascular and immune health.  To me, the evidence is in black and white and the results are evident in a multitude of my patients. The sad discovery is that despite education to clients, we can implement a course of therapy for a clinically ill pet, which then recovers but they fail to see and make the changes for other pets in the household.  Then soon we are presented that pet for health problems and seem to have to have that talk once again.

Maybe it is a problem in transference of information?  Maybe it is a lack of my ability to educate?  Or maybe it is just a lack of 'want' on behalf of us as people to take the initiative to try to head off clinical health problems?  People question the effectiveness of preventative actions, but to me the evidence is in my own pets, myself and my family.  Our 12 y.o. female Doberman has been on one of our preventative herbal formulas for the past 7 years, essentially as a guinea pig.  She had no health problems but is three legged and of average size.  At the time of this writing, she could physically pass for a dog half her age, demonstrating energy of a young dog, no pain, no stiffness and few gray hairs around the muzzle.  She runs and enjoys life to the fullest.  The last time I saw a 12 y.o Doberman as a veterinarian, he was debilitated, ridden with arthritis and could barely even stand, destined for euthanasia.  My family takes the preventative approach too, each day faithfully consuming our herbal shakes.  Considering our age and our kid's level of physical activity, we maintain our health pretty well and no medications.

The reality is that we are in charge of our health and can chose to be pro-active or reactive.  However, if we chose to be reactive and find that our therapy options are limited, there is ultimately only one to blame.

Take care,

Tom Schell, D.V.M.

Sunday, December 15, 2013

Medical Technology and Therapy Advances

I just returned from a veterinary convention, focused on horses and athletic injuries.  The hope, in attending these meetings is to gain new information, new insights into therapy for our patients.  We look to our peers and those at the center of research to give us hope and new options.  Given my background over the past few years, being involved in research, I have found myself being more critical of various therapies and actually looking for implementation of new options.

While at this convention, the topic of joint disease and tendon injuries in the horse were paramount as this is a common problem especially in the equine athlete.  We discussed technology used in making these diagnoses and reviewed some treatment options.  In the end, I walked out somewhat disappointed as the end results in the many cases presented were typical of what we have been seeing for the past 10 years with no change for the patient.

When I graduated from veterinary school, the main technology that we had at that time were 'paper' film x-rays.  They were the traditional x-ray, on paper or film, that one could take with them and hold up to a view box to read.  The technology was good, but details were missing at times.  Ultrasound technology was coming to light while I was in school and soon became a part of clinical practice, helping us to see a little deeper in terms of information and providing more information than we had before.  Next to come was MRI and CT capabilities, which had been present in the human spectrum for years, but was working its way into the Universities and now into private practices to be used in the horse and companion patients.  Personally, I was quite stunned to hear just how many private practices had this technology at their disposal as it is quite expensive and dictates a very affluent client base.

I find this technology very useful and interesting but I made some observations.  First, these new capabilities seem to be replacing the personal approach in some instances.  By this I mean that it is quite possible that we are relying on these new diagnostic techniques more instead of using our mind or our hands, evaluating the patient on a personal level.  Second, in several cases presented during the conference, it was obvious that this new technology was revealing very early stage degenerative changes in the joints and tendons that were causing significant pain for the patient.  These early stage changes were not evident by traditional diagnostic methods and prior to this technology, we would have simply shrugged our shoulders suspecting a soft tissue injury on some level, but not being completely sure.  This is a good thing, being able to pinpoint the problems, but is the new information being utilized properly?

Prevention of disease is paramount.  There is no denying this fact.  The earlier that we can detect a problem, the better or at least that is the way it should be.  The problem that I observed is that despite being able to find and localize these problems earlier, therapy options for that patient have not changed.  The same old standard approaches were used and often led to the same end results for the patient.  What was once an early stage lesion had soon progressed to an advanced problem.  Why did that happen?  Why didn't we take advantage of the situation and step outside the box, implementing other therapies that might just help?

To me, the biggest issue at hand is ongoing inflammation, which contributes to cellular changes and tissue deterioration.  This is a fact and supported by research.  It is clear that this problem exists in the horse, especially if they are on a competitive level.  We understand and see the changes develop, but yet our course of therapy is not altered.  There is so much we could do to intervene potentially and it doesn't have to be complicated nor cost a lot of money.

If we understand the research, we see that nature has provided us options in the form of herbs and overall nutrition.  Nutrition is the key to cellular health and functioning.  If we provide the proper nutrients, in the form of herbs or other sources, then we might be able to counteract the negative forces acting upon the body.  We just might be able to slow the degenerative process by managing inflammation more naturally and restoring cellular health.  To me, it is not rocket science, but yet is easily dismissed by the medical and veterinary community.

The reasoning for this is usually that science is lacking or efficacy studies have not been conducted.  There is fear of interactions with medications, fear of side effects and a general fear of the unknown.  The reality is that there is solid science to support this approach, noting marked positive changes in patients and minimal to no side effects.  If there are interactions with medications, they are usually due to similar modes of action, indicating a decreased need for that medication or there is an improvement in health, which then dictates a lack of need for that prescription.  The irony is that despite this, clinicians deny the connection, deny the research and rely more on pharmaceuticals to create changes for the patient.  They are quick to tell someone to stop using a supplement, even if positive changes are evident.

I guess in the end, it is a matter of 'thinking outside of the box' when it comes to healthcare or veterinary care.  I will admit that there are many supplements on the market that make incredible claims and most of them are unsubstantiated, creating false hope.  I do understand the skepticism on this level, but we need to realize that we shouldn't generalize and put them all into this group.

We need to realize that with today's changing healthcare society, there are new opportunities to intervene at earlier stages for our patients.  This may not include pharmaceuticals, but may just be nutritional changes for that patient.  We need to get back to the basics and realize the importance of proper nutrients on overall health and recovery. The results can be incredible and cost very little, creating a better outcome and potentially reducing future health demands.

As a doctor, we were trained to look out for the welfare of our patients and improve their health. Sometimes that means stepping outside of the box and exploring options. If we don't do this but simply rely on pharmaceutical companies and our peers to dictate our options, often accepting failure, then we are not doing our jobs. We do have a choice and I think we can do better for our patients, but it can be a hard concept to accept, especially in the face of pressure to use medications.

Just my thoughts,

Tom Schell, D.V.M.

Monday, August 20, 2012

My Thoughts

Tonight I sit here going through emails, which include synopses from various medical journals, highlighting medical research.  I have to admit that over the past 18 years of being a veterinarian, I have come to the conclusion that in many instances, we are doing things wrong or have our priorities incorrect.  We all sit around in front of the TV and hear commercials for various prescription medications and in today's world, it seems like there is a medication for every known condition.  The old adage "Just because we can...doesn't mean we should" always comes to mind when I hear about new medications or therapies being offered.  In some cases, the therapy/medication makes sense to me as a caregiver, but then again, the majority of them just seem to be a "bandaid" for a common medical condition, doing very little to resolve the problem itself.

Case in point are statin medications, which are commonly used to reduce blood cholesterol levels.  I was once prescribed one of these medications for elevated cholesterol, but quickly developed signs of muscular pain or myopathy and discontinued the medications.  After a brief recalling of clients that I have talked to over the years, I would have to guess that about 50-60% of these people are on some form of statin to control cholesterol.  Myself, I have changed over to a niacin supplement, along with other dietary supplements and dietary alterations. I also exercise routinely every morning.  Now, I will admit that I don't eat perfectly but I do exercise and try my best.  The last visit I had with my doctor, my total cholesterol was way down as well as triglycerides.  Actually, the values were down about 40 points and about 4 points out of the normal level.  The crapper, as I will say, is that my physician recommended a statin medication despite my lowering the overall level on my own.

The thing that bothers me in these scenarios is that I feel that these medications are used as a crutch instead of doing what should be done and that is dietary corrections, changes in lifestyle and exercise.  Too many people that I know on these medications lead sedentary lifestyles and their diets are severely lacking overall.  The statins may be lowering their cholesterol levels, but none of these people have remarked to me that their levels are normal.  Why?  Simply because they are not the answer in my opinion.  The other thing that bothers me about these types of medications are the long term side effects noted as a result of chronic use.  First, cholesterol is a major component of various hormones that are present in our bodies, including testosterone and progesterone.  It has been noted in a few studies that mid-aged and elderly men are exhibiting low testosterone levels which coincides with their use of statin medications.  The low testosterone levels are contributing to poor overall health.  It also makes one wonder about the recent commercials regarding "LOW T" in men.  Hmmm, wonder if this population is taking statins?  Statin use is also connected with a low level of CoQ10, which is a potent antioxidant present in the bloodstream.  Higher levels of CoQ10 are associated with improved cardiovascular health....so a lower CoQ10 level is associated with poor cardiac health.  So...are those taking statins more predisposed to cardiovascular disease despite having lowered cholesterol levels?  I don't know the answer to this, but maybe there is a paper out there somewhere.  Tonight, I was reading an abstract discussing that users of statins are 50% more prone to cataracts that those that are not and diabetics taking statins are even more predisposed to cataracts.  Why??  It appears that the lens within the eye depends on cholesterol for cellular health and the statins are lowering the available cholesterol.  Interesting as I did not know that.

The bottom line is that I think we need a different approach to disease in general, whether if that is impacting our pets, horses or ourselves.  Just because a scientist localizes a cellular pathway involved in a disease process, does not mean that we create a medication to block it WITHOUT evaluating the long term potential down the road for other metabolic pathways that might be impacted.  That is a tough thing to ask, especially in today's world of the pharmaceutical industry, who is looking at the bottom line dollar in terms of gross product sales versus the actual health of the patient.  I think we all need to be our own advocates regarding our health as well as that of our pets and horses.  We need to research and use our intuition when it comes to various therapies and not just do it because someone recommends it.

I believe that ultimately nutrition is going to be the key to all of our health problems.  The downside is that a proper diet requires work on our end and often requires supplementation to be complete.  I don't have all of the answers, but I certainly do have questions.

To you health,

Tom

Sunday, August 12, 2012

Cancer and Inflammation

Being an avid follower of various medical research information, I get emails continuously from various journals spotlighting new research information.  Just this past week, I received an email highlighting a published paper reviewing the possibility of a decreased mortality in patients that received aspirin therapy.  In the article, one researcher was noted to have stated that in their analysis they found upwards of a 37% reduction in cancer mortality in those patients taking aspirin on a routine basis, information cited in The Lancet 2012 as well as the Journal of National Cancer Institute.  The overall conclusions to the studies were that there was a noted reduction in overall mortality in cancer patients, but it was too early to determine which dose would be recommended, how often and whether or not the benefits would outweigh the risks.

I have followed cancer research with an open eye and mind over the past 6 years after my own personal diagnosis in 2006.  One of the concluding factors that I can see is that there is a strong correlation between ongoing inflammation in our bodies and the development of cancer.  The topic is too in depth for a blog setting, but the overall idea is that various inflammatory proteins are involved in the development and progression of cancer.  This, I believe, is where the aspirin therapy comes into play in terms of affecting the outcomes in some cancer patients.  Aspirin belongs to the category of medications termed non-steroidal anti-inflammatories or NSAIDS, which inhibits the production of COX-1 and COX-2, resulting in the decreased formation of prostagladins as well as thromboxane from arachidonic acid.  This new information also correlates well with the knowledge that we have had for years demonstrating that various tumors exhibit a high level of COX expression.  In veterinary medicine, for years we have utilized an NSAID medication called Piroxicam to help us manage Transitional Cell Carcinoma bladder cancer in dogs.  In some cases, the medication would help to control further progression, while in others not so much.  We have also seen over the past decades the research behind various anti-inflammatory herbs such as Curcumin or Turmeric and how these herbs can inhibit inflammatory pathways associated with various cancers at a much higher level than aspirin.  The end results, mainly in-vitro, of these research trials demonstrated various cancer cell line inhibition as a result of the herb activity.  In addition to these published studies,  I have several years of clinical use of these herbs in our veterinary cancer patients with some surprising results.

The bottom line here to me is that there is emerging proof demonstrating the correlation between inflammation and cancer development.  The biggest concern that is being expressed is that there are potential side effects with prolonged aspirin therapy, which are justified.  Some individuals may be able to tolerate, while some may have existing health conditions that would increased their risk factors with aspirin therapy.  I do think that we all need to be aware of the connection as well as the medical research that is being published and discuss it with our doctors.  I personally feel that we are all undergoing a tremendous amount of inflammation on a daily basis as a result of activity, various food being eaten as well as lifestyle influences.  This has led to the dramatic rise in various health conditions such as diabetes, obesity, arthritis and cancer development.  We need to be proactive and recognize that this problem exists.  I feel that aspirin therapy may be a good thing for some individuals, but there is a better opportunity for us to head off this inflammatory pathway by the use of diet and various herbal therapies.  The results may be even better in the long term and the side effects much fewer. There are so many herbs that exhibit anti-inflammatory benefits such as Curcumin, Boswellia and Ashwaghanda....the list goes on.  Many of these same herbs have supporting data to show benefits against cancer development.

With my cancer diagnosis, it shed new light on natural therapies.  I have been a long term user of a product called Cur-OST, which is formulated to target inflammation in the body.  I wouldn't go a day without it and honestly, if I miss a day....I know it.  Google it and check it out.

Food for thought.

Tom

Tuesday, August 7, 2012

Responsibility

For the past 18 years we have assisted those in need, owners of animals of all shapes, sizes and temperaments.  We have had dogs, cats, pocket pets, a few birds, horses and even cattle grace our doors with multitudes of problems.  Some bite, some lick, some shy away in fear and some just don't care one way or the other.  The same can be said about the owners of these animals: some lick, some bite, some shy away and yes, some just don't care.  The bottom line is that as an animal owner, we are all responsible for their well being and overall health, much the same as each of us is responsible for OUR own health.  Essentially, what you put into it, you get out.

Animals are dependent upon us to feed them and trust us to provide a good environment.  Our health, as well as theirs, dictates the medical problems that are plagued upon us.  We have had very overweight animals, including horses, come through our doors with a variety of medical problems that are directly tied to their diet and body condition.  Ironically, many of the owners are in the same condition and most likely have the identical health problems themselves.  It can be frustrating, as a veterinarian, to be presented with these animals because the treatment regimen is not an easy one, although the owner would like it to be simple.

If we take poor care of our pets and ourselves in terms of diet, exercise and environmental factors, we have to be prepared for the repercussions.  An overweight dog that presents with diabetes entails not only insulin therapy, but a change in diet and weight loss.  They go hand in hand.  A diabetic human that is overweight, cannot continue to eat candy bars, take insulin and expect to get the disease under control.  So, why is this not logical to the many?  Why do we have pet owners that get upset when their pet's sugar levels are not controlled, when they have not addressed the diet aspect and have not improved exercise levels?  They look to us, as veterinarians, or physicians, as having a magic blue pill that will just make everything go away so that they can continue to feed their pet or themselves junk food as if the disease never existed.

The bottom line is that we have to be responsible for our own health and that of our animals.  The only person to be upset with is ourselves on both aspects.  If we or our pet is sick with a chronic disease, the fact is that we are to blame.  Too many diseases in today's society are highly preventable with adequate exercise, the proper diet and the correct environment.  We can make the changes necessary to improve the health of our pets as well as ourselves.  It really is simple, but it requires effort.  Just do me a favor and don't point the finger at your veterinarian or your family doctor.  Look in the mirror for the one to blame.

Food for thought.

Tom Schell, D.V.M.

Thursday, August 2, 2012

Beginnings

Welcome to my personal blog!  As a veterinarian and avid researcher of medical information, I have several thoughts on my mind at any given time.  I think there is much out there that needs to be spoken and brought to light regarding our personal health as well as that of our four legged friends, including horses.  As a brief introduction, I have been a mixed animal veterinarian for over 18 years, which means essentially that we have worked on horses, cattle as well as companion animals in our practice.  Over the past 6 years, I have become very involved in alternative therapies as well as research investigating the potential for herbs as well as dietary therapies in our overall health, as well as that with our animal friends.  This alternative pathway in my career developed after a personal bout with cancer back in 2006, which led me to "see the light" in terms of what the disease was truly about, how it occurs and what treatment options are out there.  I also realized quickly how closely connected various disease are to cancer, such as arthritis and other degenerative conditions, leading to a connection in the potential therapies. 

I hope to use this blog to relay my personal thoughts on various issues, medical and non-medical, as well as to relay pertinent research information that I feel everyone should be aware of.  Feel free to share your thoughts as well, if desired, for we all have a lot to learn from one another.

Until next time. . .

Tom Schell, D.V.M.